Zepbound vs. Farxiga
See how Zepbound and Farxiga compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Zepbound is a weekly injection approved for weight loss and sleep apnea, while Farxiga is a daily pill approved for diabetes, heart failure, and kidney disease.
Farxiga can cause modest weight loss as an off-label side effect, but it is far less effective for shedding pounds than Zepbound.
Zepbound typically costs more per month out of pocket than Farxiga, though insurance coverage depends heavily on the specific indication being treated.
Zepbound vs. Farxiga Drug Summary
Zepbound
Zepbound (tirzepatide) is a dual GLP-1/GIP receptor agonist approved for chronic weight management in adults with obesity, or overweight plus a weight-related condition, and for moderate-to-severe obstructive sleep apnea in adults with obesity. It is injected under the skin once a week. The dose is increased gradually over about five months to help limit side effects.
Farxiga
Farxiga (dapagliflozin) is an SGLT2 inhibitor that lowers blood sugar by causing the kidneys to release extra glucose into the urine. It is approved for type 2 diabetes, heart failure, and chronic kidney disease, and is taken as a tablet once a day. It is not FDA-approved for weight loss, although modest weight loss can occur as a side effect.
Zepbound vs. Farxiga Side Effects
Zepbound
Farxiga
Zepbound vs. Farxiga Dosage
Zepbound
Farxiga
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once weekly | Weeks 1-4 |
| Maximum dose | 15 mg once weekly | Week 21 onward |
| Dose changes | 5 increases | Every 4 weeks |
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Zepbound
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once weekly | Weeks 1-4 |
| Maximum dose | 15 mg once weekly | Week 21 onward |
| Dose changes | 5 increases | Every 4 weeks |
Farxiga
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 10 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Zepbound vs. Farxiga Indications
Zepbound
Zepbound is FDA-approved for two separate uses: chronic weight management and moderate-to-severe obstructive sleep apnea, both in adults with obesity. It must be used alongside a reduced-calorie diet and increased physical activity. It is not approved to treat type 2 diabetes.
Chronic weight management in adults with obesity or overweight plus a related condition
Moderate-to-severe obstructive sleep apnea in adults with obesity
Used together with a reduced-calorie diet and increased physical activity
Not approved for type 2 diabetes, which is treated under the brand Mounjaro
Farxiga
Farxiga is FDA-approved for four related uses: type 2 diabetes, heart failure, and chronic kidney disease, in adults and in some cases children age 10 and older. It is not approved for weight loss, though this is a common off-label use. It is also not approved for type 1 diabetes.
Blood sugar control in type 2 diabetes, including children age 10 and older
Reducing heart failure hospitalization risk in adults with cardiovascular risk factors
Treating heart failure to reduce cardiovascular death and hospitalization
Slowing kidney function decline in chronic kidney disease
Zepbound vs. Farxiga Pros and Cons
Zepbound
Zepbound produces some of the largest average weight-loss results seen in clinical trials, and it is the only medication also approved for obstructive sleep apnea. It requires a weekly self-injection and carries a higher monthly list price than oral options like Farxiga.
Pros
Larger average weight loss than SGLT2 inhibitors in clinical trials
Only medication FDA-approved for both weight loss and obstructive sleep apnea
Only needs to be injected once a week
Dose is increased slowly over months to help limit side effects
Cons
Requires self-injection rather than a pill
Common gastrointestinal side effects like nausea and diarrhea
Roughly $1,050 to $1,100 per month without insurance, before savings programs
Not approved for diabetes, heart failure, or kidney disease
Farxiga
Farxiga has a long track record and covers four separate conditions, including diabetes, heart failure, and kidney disease. It is taken as a daily pill rather than an injection, but any weight loss it causes is a side effect rather than its intended purpose.
Pros
Taken as a once-daily pill, no injections needed
Roughly $400 to $785 per month without insurance, before savings programs
Also treats heart failure and chronic kidney disease
Long-standing FDA approval since 2014 with extensive safety data
Cons
Weight loss is modest and considered an off-label side effect
Risk of genital yeast infections and urinary tract infections
Rare risk of serious genital infections like Fournier's gangrene
Not intended or approved as a weight-loss treatment
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